Look up the most recent NPI and PECOS records

Susquehanna Physician Services

(<Unavail>)

Family Medicine

Allopathic & Osteopathic Physicians

1201 Grampian Blvd, Williamsport, PA 17701-1900

PECOS Enrollment

Based on the most recent information from CMS, provider Susquehanna Physician Services does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1831145515
Provider Type
Organization
Full Name
Susquehanna Physician Services
Other Name
<Unavail>

Subpart
No
Enumeration Date
5/25/2006
Last Updated
11/24/2015

Contact Information

Practice Location

1201 Grampian Blvd, Williamsport, PA 17701-1900

(570) 326-8723

(570) 326-8922

Mailing Location

1201 Grampian Blvd, Williamsport, PA 17701-1900

Unlisted Phone

Unlisted Fax

Authorized Official

Davis, Melissa (Vp/Coo)

(570) 320-7696

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 207RR0500X	Description Internal Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 208VP0000X	Description Pain Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 207N00000X	Description Dermatology Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 208100000X	Description Physical Medicine & Rehabilitation Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 207RC0000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 207RE0101X	Description Internal Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 207RI0011X	Description Internal Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 207RP1001X	Description Internal Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 208600000X	Description Surgery Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 207Y00000X	Description Otolaryngology Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 2084P0800X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License Unlisted Issuer

Susquehanna Physician Services

(<Unavail>)

PECOS Enrollment

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